scholarly journals Programmed Labor—Indegenous Protocol to Optimize Labor Outcome

2009 ◽  
Vol 1 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Narendra Malhotra ◽  
Ameet Patki ◽  
Uday Thanawala ◽  
Amarnath Bhide ◽  
Shirish N Daftary ◽  
...  
Keyword(s):  
Pain Relief ◽  
Blood Loss ◽  
Selection Criteria ◽  
Obstetric Outcome ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Matching Trial ◽  
Parallel Group ◽  
Third Stage ◽  
Active Labor

ABSTRACT Objective To Asses and develop an indigenous protocol to optimize labour outcome, as Programmed Labor. Design Open, prospective (Between January 2000 to December 2007), randomized, parallel group, monocentric, comparative matching trial. Settings Labor rooms at Nowrosjee Wadia Maternity, Mumbai. Selection criteria 200 patients in each group, aged between 21-30, as low-risk parturient. Intervention Partography, Oxytocin, Primiprost, Pentazocin, Dizepam, Tramadol, Drotin, Ketamine. Outcome parameters Satisfactory obstetric outcome, progressive labor of shorter duration, less blood loss and pain relief. Results Study group had mean shorter duration of active labor as 3.5 hrs compared to controls of 5.2 hrs. Excellant pain relief was of 24 and 62% of substantial relief in comparison to 32% only in other group with no patient falling in excellent group. Second stage of labor was reduced by half (26 to 48 meters) and lesser third stage blood loss. Conclusions Programmed labor with indigenous protocol developed and practiced, results in progressive, shorter, and comfortable labors with lesser blood loss.

The Effects of an External Nasal Dilator on Labor

2005 ◽  
Vol 19 (2) ◽  
pp. 221-224 ◽  
Author(s):  
Oscar Sadan ◽  
Sagit Shushan ◽  
Ido Eldar ◽  
Shmuel Evron ◽  
Samuel Lurie ◽  
...  
Keyword(s):  
Active Phase ◽  
Well Being ◽  
Control Group ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Satisfaction Rate ◽  
Several Variables ◽  
Active Labor ◽  
Meconium Stained Amniotic Fluid

Background The aim of this study was to assess the effect of an external nasal dilator on several variables characterizing labor in both mother and fetus. Methods One hundred and fifty primigravida women in active labor were randomized to wear, throughout labor, either a dilator spring-loaded nasal strip or a placebo device. Data were obtained during labor and compared between the groups. After delivery, the satisfaction rate was assessed. Results No differences were found between the study and the control group regarding rate of induction or augmentation of labor as well as Montevideo units reached, frequency of rupture of membranes, duration of the active phase and second stage of labor, usage of epidural analgesia, normal fetal heart pattern, meconium-stained amniotic fluid, and neonatal well being. Length of maternal and neonatal hospitalization also did not differ between the groups. Satisfaction rate was significantly higher in parturient women wearing nasal strips with a dilator spring than in parturient women wearing a placebo spring (P < 0.0001). Conclusion Nasal strips do not change the course but ameliorate the quality of labor by improving the ease of breathing. Nasal dilators sustain the respiratory effort associated with the long process of labor and may control the switch from nasal to oronasal breathing during delivery.

scholarly journals Natural and Synthetic Oxytocin—Structurally Same but Differ in Effects—A Pilot Study

2021 ◽  
Author(s):  
Katarzyna Wszołek ◽  
Karolina Chmaj-Wierzchowska ◽  
Małgorzata Pięt ◽  
Agata Tarka ◽  
Maciej Wilczak
Keyword(s):  
Umbilical Cord ◽  
Labor Induction ◽  
Active Management ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Synthetic Oxytocin ◽  
Umbilical Cord Vein

Abstract Purpose: synthetic oxytocin is currently used to induce labor and strengthen the contractile function in the first or second stage of labor. It is also used therapeutically and prophylactically in the third stage of labor. We aimed to correlate the dose and duration of synthetic oxytocin infusions used during induction of labor, augmentation of labor in the first and second stage of labor, and during active management of labor in the third stage of labor to the level of prolactin and cortisol in the serum of the parturient blood and from the umbilical cord vein.Methods: The mother’s blood was collected from a venous vessel and foetal from the umbilical cord vein just cutting was performed and the levels of cortisol and prolactin was evaluated by electrochemiluminescence (ECLIA). The blood sample from the umbilical cord vein and artery were collected to separate heparinized capillaries and the pH, base deficit (BD), pO2, and CO2 concentration were assessed.Results: We observed decreased level of prolactin immediately after the labor depending on the total dose of synthetic oxytocin used. We did not observe any relationship between the level of prolactin on postpartum day 2 on the dose of administered hormone or the fact of the labor induction. We observed significant correlations with regard to hormone levels without the synthetic oxytocin total dosage correlation. Conclusion: We strongly believe that the definition of uniform norms and principles with regard to the dosage of synthetic oxytocin for labor induction should be determined.

scholarly journals A comparative study of the effects of programmed labour protocol and expectant management of labour

2017 ◽  
Vol 6 (12) ◽  
pp. 5536
Author(s):  
Anjuman Alam ◽  
Swapnil Goswami
Keyword(s):  
Pain Relief ◽  
Blood Loss ◽  
Apgar Score ◽  
Expectant Management ◽  
Active Phase ◽  
Third Stage ◽  
Good Pain Relief ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Childbirth is one of the most wonderful and anticipated moments in a woman’s life. But the excruciating pain associated with labour makes it a really undesirable one. Objective of present study was to compare the effects of programmed labour protocol and expectant management of labour.Methods: A clinical study was conducted on 120 low risk primigravida, 60 of them were managed with programmed labour protocol (group A) and the rest 60 (group B) were managed expectantly. Primary parameters were pain relief and changes in the mean duration of labour. Secondary parameters were changes in the amount of blood loss and APGAR score of delivered babies.Results: Among group A, 25% had good pain relief, 60% had moderate pain relief, 15% had mild pain relief and 0% had no relief of pain. The mean duration of labour from active phase through third stage in group A was 234.27±50.38 minutes and 304.58±41.72 minutes in group B. The average blood loss during labour was 89.33±19.06 ml in group A and 142.15±32.27 ml in group B. In group A, 4 babies had APGAR score less than 7 at 1 minute, but had score more than 7 after 5 minutes following resuscitation. In group B, 9 babies had APGAR less than 7 at 1 minute. Of these, 6 babies had score more than 7 after 5 minutes following resuscitation. 3 babies had score less than 7 even after 5 minutes and were shifted to neonatal ICU.Conclusions: Programmed labour protocol is an effective method to reduce the deleterious effects of labour on both mother and foetus. 

Epidurals and the Modern Labor Curve: How Epidural Timing Impacts Fetal Station during Active Labor

2017 ◽  
Vol 35 (05) ◽  
pp. 421-426
Author(s):  
Methodius Tuuli ◽  
Molly Stout ◽  
Candice Woolfolk ◽  
Kimberly Roehl ◽  
George Macones ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Primary Outcome ◽  
Secondary Analysis ◽  
Single Institution ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Increased Risk ◽  
Active Labor ◽  
Secondary Outcomes ◽  
Singleton Pregnancies

Objective The objective of this study was to estimate epidural timing's impact on fetal station during active labor. Study Design This secondary analysis of a single-institution prospective cohort study included all term singleton pregnancies, stratified by parity. Those with early epidurals (placed at <6 cm) were compared with those with late epidurals (placed at ≥6 cm). The primary outcome was median fetal station from 6 to 10 cm. Secondary outcomes included rate of prolonged first or second stage of labor (>95%). Multivariable logistic regression adjusted for labor type. Results Among 7,647 women, 3,434 were nulliparous (2,983 with early epidurals and 451 with late epidurals) and 4,213 multiparous (3,141 with early epidurals and 1,072 with late epidurals). Interquartile ranges (IQRs) suggested fetal station at 6 cm was likely lower among those with early epidurals (nulliparous: median head station −1 [IQR: −1 to 0] for early epidural vs. −1 [IQR: −2 to 0] for late epidural, p < 0.01; multiparous: −1 (IQR: −2 to 0] for early epidural vs. −1 [IQR: −3 to −1] for late epidural, p < 0.01). Early epidurals were not associated with increased risk of prolonged first stage, but among nulliparous were associated with decreased risk of prolonged second stage (adjusted odds ratio: 0.66 [95% confidence interval: 0.44–0.99]). Conclusion Early epidurals were associated with lower fetal station in active labor but not prolonged first stage.

Management in Second Stage of Labour in Term Twin Delivery

1985 ◽  
Vol 34 (3-4) ◽  
pp. 213-216 ◽  
Author(s):  
P. Olofsson ◽  
H. Rydhström
Keyword(s):  
Selection Criteria ◽  
Vaginal Route ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Simple Program ◽  
Twin Delivery

AbstractA simple program for management of term twin delivery in the second stage of labor is presented. Provided that given selection criteria are met, twins at term are delivered by the vaginal route

scholarly journals Risk Factors for Postpartum Hemorrhage and its Severe Forms with Blood Loss Evaluated Objectively – A Prospective Cohort Study

2021 ◽  
Vol 43 (02) ◽  
pp. 113-118
Author(s):  
Anderson Borovac-Pinheiro ◽  
Filipe Moraes Ribeiro ◽  
Rodolfo Carvalho Pacagnella
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Blood Loss ◽  
Prospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Prospective Cohort ◽  
Early Recognition ◽  
Univariate Analysis ◽  
Second Stage Of Labor ◽  
Second Stage

Abstract Objective To identify risk factors related to postpartum hemorrhage (PPH) and severe PPH with blood loss quantified objectively. Methods This is a complementary analysis of a prospective cohort study that included pregnant women delivering vaginally. The total blood loss was obtained through the sum of the volume collected from the drape with the weight of gauzes, compresses and pads used by women within 2 hours. Exploratory data analysis was performed to assess mean, standard deviation (SD), frequency, percentage and percentiles. The risk factors for postpartum bleeding were evaluated using linear and logistic regression. Results We included 270 women. The mean blood loss at 120 minutes was 427.49 mL (±335.57 mL). Thirty-one percent (84 women) bled > 500 mL and 8.2% (22 women) bled > 1,000 mL within 2 hours. Episiotomy, longer second stage of labor and forceps delivery were related to blood loss > 500 mL within 2 hours, in the univariate analysis. In the multivariate analysis, only forceps remained associated with bleeding > 500 mL within 2 hours (odds ratio [OR] = 9.5 [2.85–31.53]). Previous anemia and episiotomy were also related to blood loss > 1,000mL. Conclusion Prolonged second stage of labor, forceps and episiotomy are related to increased incidence of PPH, and should be used as an alert for the delivery assistants for early recognition and prompt treatment for PPH.

Second stage of labor in the age of epidural anesthesia

1998 ◽  
Vol 5 (1) ◽  
pp. 171A-171A
Author(s):  
E XENAKIS ◽  
J PIPER ◽  
M MCFARLAND ◽  
C SUITER ◽  
O LANGER
Keyword(s):  
Epidural Anesthesia ◽  
Second Stage Of Labor ◽  
Second Stage

The Coherence of Mary Barton: Romance, Realism, and Utopia

2015 ◽  
Vol 5 (3) ◽  
pp. 185-200
Author(s):  
Robert Z. Birdwell
Keyword(s):  
Thomas Carlyle ◽  
The Novel ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Three Stages ◽  
Mode Of Production

Critics have argued that Elizabeth Gaskell's first novel, Mary Barton (1848), is split by a conflict between the modes of realism and romance. But the conflict does not render the novel incoherent, because Gaskell surpasses both modes through a utopian narrative that breaks with the conflict of form and gives coherence to the whole novel. Gaskell not only depicts what Thomas Carlyle called the ‘Condition of England’ in her work but also develops, through three stages, the utopia that will redeem this condition. The first stage is romantic nostalgia, a backward glance at Eden from the countryside surrounding Manchester. The second stage occurs in Manchester, as Gaskell mixes romance with a realistic mode, tracing a utopian drive toward death. The third stage is the utopian break with romantic and realistic accounts of the Condition of England and with the inadequate preceding conceptions of utopia. This third stage transforms narrative modes and figures a new mode of production.

How well do voice-hearing assessment measures capture the positive experiences of individuals?

2019 ◽  
Author(s):  
Lucy Armstrong ◽  
Lorna Hogg ◽  
Pamela Charlotte Jacobsen
Keyword(s):  
Systematic Review ◽  
Lived Experience ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Hearing Assessment ◽  
Positive Experiences ◽  
Assessment Measures ◽  
Stage 1 ◽  
The Voice

The first stage of this project aims to identify assessment measures which include items on voice-hearing by way of a systematic review. The second stage is the development of a brief framework of categories of positive experiences of voice hearing, using a triangulated approach, drawing on views from both professionals and people with lived experience. The third stage will involve using the framework to identify any positve aspects of voice-hearing included in the voice hearing assessments identified in stage 1.

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